Display options
Cite
Bruckmann NM, Kirchner J, Morawitz J, et al. Prospective comparison of CT and 18F-FDG PET/MRI in N and M staging of primary breast cancer patients: Initial results. PLoS One. 2021;16(12):e0260804doi: 10.1371/journal.pone.0260804.
Bruckmann, N. M., Kirchner, J., Morawitz, J., Umutlu, L., Herrmann, K., Bittner, A. K., Hoffmann, O., Mohrmann, S., Ingenwerth, M., Schaarschmidt, B. M., Li, Y., Stang, A., Antoch, G., Sawicki, L. M., & Buchbender, C. (2021). Prospective comparison of CT and 18F-FDG PET/MRI in N and M staging of primary breast cancer patients: Initial results. PloS one, 16(12), e0260804. https://doi.org/10.1371/journal.pone.0260804
Bruckmann, Nils Martin, et al. "Prospective comparison of CT and 18F-FDG PET/MRI in N and M staging of primary breast cancer patients: Initial results." PloS one vol. 16,12 (2021): e0260804. doi: https://doi.org/10.1371/journal.pone.0260804
Bruckmann NM, Kirchner J, Morawitz J, Umutlu L, Herrmann K, Bittner AK, Hoffmann O, Mohrmann S, Ingenwerth M, Schaarschmidt BM, Li Y, Stang A, Antoch G, Sawicki LM, Buchbender C. Prospective comparison of CT and 18F-FDG PET/MRI in N and M staging of primary breast cancer patients: Initial results. PLoS One. 2021 Dec 02;16(12):e0260804. doi: 10.1371/journal.pone.0260804. eCollection 2021. PMID: 34855886; PMCID: PMC8638872.
Copy Download .nbib Format: NLM
Share it on

PLoS One. 2021 Dec 02;16(12):e0260804. doi: 10.1371/journal.pone.0260804. eCollection 2021.

Prospective comparison of CT and 18F-FDG PET/MRI in N and M staging of primary breast cancer patients: Initial results.

PloS one

Nils Martin Bruckmann, Julian Kirchner, Janna Morawitz, Lale Umutlu, Ken Herrmann, Ann-Kathrin Bittner, Oliver Hoffmann, Svjetlana Mohrmann, Marc Ingenwerth, Benedikt M Schaarschmidt, Yan Li, Andreas Stang, Gerald Antoch, Lino M Sawicki, Christian Buchbender

Affiliations

  1. Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany.
  2. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
  3. Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
  4. Department Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
  5. Department of Gynecology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany.
  6. Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen and the German Cancer Consortium (DKTK), Essen, Germany.
  7. Institute of Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany.

PMID: 34855886 PMCID: PMC8638872 DOI: 10.1371/journal.pone.0260804

Abstract

OBJECTIVES: To compare the diagnostic accuracy of contrast-enhanced thoraco-abdominal computed tomography and whole-body 18F-FDG PET/MRI in N and M staging in newly diagnosed, histopathological proven breast cancer.

MATERIAL AND METHODS: A total of 80 consecutive women with newly diagnosed and histopathologically confirmed breast cancer were enrolled in this prospective study. Following inclusion criteria had to be fulfilled: (1) newly diagnosed, treatment-naive T2-tumor or higher T-stage or (2) newly diagnosed, treatment-naive triple-negative tumor of every size or (3) newly diagnosed, treatment-naive tumor with molecular high risk (T1c, Ki67 >14%, HER2neu over-expression, G3). All patients underwent a thoraco-abdominal ceCT and a whole-body 18F-FDG PET/MRI. All datasets were evaluated by two experienced radiologists in hybrid imaging regarding suspect lesion count, localization, categorization and diagnostic confidence. Images were interpreted in random order with a reading gap of at least 4 weeks to avoid recognition bias. Histopathological results as well as follow-up imaging served as reference standard. Differences in staging accuracy were assessed using Mc Nemars chi2 test.

RESULTS: CT rated the N stage correctly in 64 of 80 (80%, 95% CI:70.0-87.3) patients with a sensitivity of 61.5% (CI:45.9-75.1), a specificity of 97.6% (CI:87.4-99.6), a PPV of 96% (CI:80.5-99.3), and a NPV of 72.7% (CI:59.8-82.7). Compared to this, 18F-FDG PET/MRI determined the N stage correctly in 71 of 80 (88.75%, CI:80.0-94.0) patients with a sensitivity of 82.1% (CI:67.3-91.0), a specificity of 95.1% (CI:83.9-98.7), a PPV of 94.1% (CI:80.9-98.4) and a NPV of 84.8% (CI:71.8-92.4). Differences in sensitivities were statistically significant (difference 20.6%, CI:-0.02-40.9; p = 0.008). Distant metastases were present in 7/80 patients (8.75%). 18 F-FDG PET/MRI detected all of the histopathological proven metastases without any false-positive findings, while 3 patients with bone metastases were missed in CT (sensitivity 57.1%, specificity 95.9%). Additionally, CT presented false-positive findings in 3 patients.

CONCLUSION: 18F-FDG PET/MRI has a high diagnostic potential and outperforms CT in assessing the N and M stage in patients with primary breast cancer.

Conflict of interest statement

The authors have declared that no competing interests exist.

References

  1. PLoS One. 2017 Jul 6;12(7):e0180349 - PubMed
  2. Eur J Radiol. 2016 Feb;85(2):459-65 - PubMed
  3. Ann Oncol. 2015 Sep;26 Suppl 5:v8-30 - PubMed
  4. J Clin Oncol. 2008 Oct 10;26(29):4746-51 - PubMed
  5. Eur J Radiol. 2017 Apr;89:14-19 - PubMed
  6. J Nucl Med. 2014 Mar;55(3):373-8 - PubMed
  7. CA Cancer J Clin. 2019 Nov;69(6):438-451 - PubMed
  8. Eur J Radiol. 2013 Nov;82(11):e669-75 - PubMed
  9. Ann Surg Oncol. 2012 Jun;19(6):1825-30 - PubMed
  10. Eur J Nucl Med Mol Imaging. 2015 Jan;42(1):56-65 - PubMed
  11. J Nucl Med. 2016 Apr;57(4):582-6 - PubMed
  12. Eur J Radiol. 2013 Nov;82(11):2005-10 - PubMed
  13. Int J Radiat Oncol Biol Phys. 2008 Jul 1;71(3):695-704 - PubMed
  14. J Nucl Med. 2016 Jan;57(1):15-20 - PubMed
  15. Radiology. 2016 Oct;281(1):193-202 - PubMed
  16. J Clin Oncol. 2016 Jun 1;34(16):1889-97 - PubMed
  17. Eur J Nucl Med Mol Imaging. 2018 Feb;45(2):179-186 - PubMed
  18. Geburtshilfe Frauenheilkd. 2018 Nov;78(11):1056-1088 - PubMed
  19. Sci Rep. 2019 Oct 1;9(1):14111 - PubMed
  20. Ann Oncol. 2008 Jul;19(7):1249-1254 - PubMed
  21. AJR Am J Roentgenol. 2013 Mar;200(3):W314-20 - PubMed
  22. Eur Radiol. 2019 Apr;29(4):1787-1798 - PubMed
  23. Semin Nucl Med. 2015 Jul;45(4):304-21 - PubMed
  24. J Clin Oncol. 2007 Sep 1;25(25):3923-9 - PubMed
  25. Ann Nucl Med. 2009 Dec;23(10):855-61 - PubMed
  26. J Natl Compr Canc Netw. 2018 Mar;16(3):310-320 - PubMed
  27. Indian J Surg Oncol. 2019 Sep;10(3):483-488 - PubMed
  28. Radiol Bras. 2017 Jul-Aug;50(4):211-215 - PubMed
  29. Cancer. 2009 Nov 1;115(21):5095-107 - PubMed
  30. JAMA. 2013 Nov 27;310(20):2191-4 - PubMed
  31. Invest Radiol. 2015 Aug;50(8):505-13 - PubMed
  32. Ann Thorac Surg. 2011 Nov;92(5):1826-32; discussion 1832 - PubMed
  33. J Breast Cancer. 2012 Dec;15(4):441-8 - PubMed
  34. Eur J Nucl Med Mol Imaging. 2019 Feb;46(2):437-445 - PubMed
  35. Ann Oncol. 2018 Aug 1;29(8):1634-1657 - PubMed
  36. Eur J Nucl Med Mol Imaging. 2018 Apr;45(4):622-629 - PubMed
  37. Eur J Nucl Med Mol Imaging. 2018 Dec;45(13):2328-2337 - PubMed
  38. Aust Fam Physician. 2012 Nov;41(11):871-4 - PubMed

Publication Types